Maybe you, too, are familiar with this situation: As a patient diagnosed with polycystic ovary syndrome (PCOS) and admittedly a few pounds too much on your hips, your doctor has recommended that you lose weight. It is not about a taste aberration in the direction of beanstalk-preference, but quite important for your health. Each kilo less brings your hormone system back into balance and counteracts any existing insulin resistance and thus the risk of diabetes. The reward for your effort is also a more even skin, more energy in everyday life, and even beautiful hair. The problem: You have nothing against the idea of losing a few pounds. You would really like that. Very much so. You’ve tried everything, you know the latest diet trends better than any Hollywood nutrition guru – and yet the pounds are still there.
Why is weight loss so difficult with PCOS?
A new study published at the end of 2018 in a journal for nutritional sciences now gives some clues as to where the problem could lie: in the study, a team of Canadian scientists shows clearly what you have already learned from many years of experience: your weight problems cannot be attributed to overeating, or too little exercise – that’s why normal dieting methods don’t do the trick for you. The fact that weight loss is particularly difficult for PCOS patients is, according to the study, mainly due to other reasons, which are usually ignored in normal diets.
What does research show?
The researchers compared the eating behavior of overweight women with polycystic ovarian syndrome (PCOS) to that of women without obesity and PCOS. The results did not confirm what most of us (and often especially our – certainly well-meaning – near and dear ones) think they know: PCOS patients neither consumed more calories, nor did they move less than women without PCOS. Exciting, the researchers thought, and, searching for differences, looked again in more detail. They found what they were looking for when comparing the dietary fiber content: Women with PCOS consumed significantly less fiber than women from the comparison group. They also consumed significantly less magnesium. Interestingly another study from 2016 had previously shown that the micronutrient carnitine is often less present in PCOS patients than in healthy controls.
Weight loss formula for PCOS patients
The great thing about these results is that patients with PCOS can use them in their everyday lives: instead of chastising themselves with diets, the goal should be to address the scientifically shown problems in three steps: Change your diet to a wholesome diet, increase the amount of fiber in your diet and bring your vital substance balance back into balance.
That’s how it’s done – whole foods diet
A healthy diet in polycystic ovary syndrome is balanced, varied and wholefood. It should not only taste good, but also provide the body with adequate energy sources, building blocks, as well as vitamins and minerals. The basic nutrition of PCOS is based on the so-called food pyramid, whereby as far as possible no industrially processed foods are used. Food should come from organic farming, be harvested when ripe and have no long transportation (preferred choice of regional and seasonal products). Another important focus is the prevention of blood sugar spikes and the restoration of a balanced lipid metabolism (keyword: healthy fats). Valuable micronutrients should be delivered to the body abundantly, so that the metabolism can run smoothly again.
More fiber
Fibers were once thought to be unnecessary ballast. Today we know that fiber from grains, legumes, fruits, and vegetables not only has regulating effects on digestive activity, satiety and blood sugar levels, but also contributes significantly to intestinal health. According to recent findings, it is also important for the cardiovascular system and can even reduce inflammatory conditions in the body. For PCOS patients, fiber is beneficial for a number of health reasons and can effectively support a healthy weight. Instead of paying attention only to the calorie and carbohydrate content, it makes sense to aim for a change to a whole food and varied diet, and to pay particular attention to integrating more fiber into the daily diet. Very easily you will succeed with these tips:
Replace white flour with whole grain flour as often as possible. Choose wholegrain bread instead of white bread, whole wheat pasta instead of white, brown rice instead of white, etc. In addition to that, you can boost the fiber content of your food by sprinkling a bit of oat bran over your yoghurt. Flaxseeds are also great and score high with their content of healthy fats.
Tip: In order for fiber to fully excert its positive effects, sufficient drinking (at least 1.5 liters of non-sugary drinks per day) is especially important! !
Other good fiber sources are legumes of all kinds. Personally, I like to mix red lentils with many meals – my family usually doesn’t even notice. Just add a few red lentils to the Bolognese sauce, mix with (brown) rice, etc – looks great too due to its beautiful color
Balancing vital substances
As shown above, especially in PCOS, it is important to ensure an adequate supply of valuable vitamins, minerals and other micronutrients. This includes a regular check of your vitamin D level as well as the abundant consumption of vegetables and fruits. Obviously, if you want to lose weight, you need to take care of your magnesium and carnitine supply.
Magnesium
Magnesium is a vital mineral that you need to absorb in your diet.
It is needed daily for the function of your muscles and your nervous system, it is involved in building bones and teeth, it plays a role in carbohydrate metabolism and much more.
The daily magnesium needs differ depending on the age group and gender. The German Society for Nutrition (DGE) recommends for women over 25 a daily intake of 300 milligrams. Pregnant and nursing women need a little more.
There are many natural sources of magnesium that can be incorporated into the daily diet. Mineral water is one of the best sources of magnesium. Make sure that at least 50 milligrams per liter are included. Whole grain cereals, nuts and legumes are also very good magnesium sources.
Basically, the more natural the food, the higher the mineral content, which translates to highly processed products often containing only little magnesium.
Secret weapon carnitine
For weight problems and PCOS, there is an additional helper: carnitine. It is a naturally occurring combination of the protein building blocks lysine and methionine and is especially important for cellular energy metabolism.
Patients with polycystic ovarian syndrome often have significantly lower carnitine levels than healthy women. Incidentally, this applies to overweight as well as normal weight PCOS patients. Good carnitine intake may then be helpful in assisting weight loss programs and normalizing insulin levels.
You should take 1 to 3 grams of L-carnitine daily in your diet. Plant products generally have a low carnitine content. Small amounts are found in pasta, broccoli and potatoes. Foods with a high L-carnitine content include meat, fish and dairy products.
Anyone who is unsure can, of course, also make use of special nutritional supplements, which already contain all vital substances in a combination tailored to the special needs of PCOS.
Additional tip: Intermittent fasting
Another apsect to reduce weight successfully in PCOS is intermittent fasting. Studies show that women who follow an intermittent fasting protocoll, in which they eat only during eight hours (e.g. between 8 AM and 4 PM or only between 11 AM and 7 PM) with 16 h of fasting per day, can experience significant benefits after only 6 weeks: Patients not only lost considerable weight, but also had improved hormonal balance and metabolism.
Avoiding simple carbohydrates
Keeping blood sugar levels even helps to reduce cravings. Avoid simple carbohydrates, prefer whole grain products to white flour and combine carbs with proteins and lipids to reduce possible blood sugar spikes. For example, if you really want to have some sweets, do so after a normal meal. This way, sweets and healthy food will be digested together, moderating the effect on blood sugar levels.
References
Afshar Ebrahimi F et al. , The Effects of Magnesium and Zinc Co-Supplementation on Biomarkers of Inflammation and Oxidative Stress, and Gene Expression Related to Inflammation in Polycystic Ovary Syndrome: a Randomized Controlled Clinical Trial. Biol Trace Elem Res. 2018 Aug;184(2):300-307. doi: 10.1007/s12011-017-1198-5. Epub 2017 Nov 10.
Celik F et al. Plasma L-carnitine levels of obese and non-obese polycystic ovary syndrome patients. J Obstet Gynaecol. 2017 May;37(4):476-479.
Cutler DA et al. Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Sci Nutr. 2019 Feb 27;7(4):1426-1437. doi: 10.1002/fsn3.977. eCollection 2019 Apr.
Fenkci SM et al. Serum total L-carnitine levels in non-obese women with polycystic ovary syndrome. Hum Reprod. 2008 Jul;23(7):1602-6.
Feyzioglu BS, Güven CM, Avul Z. Eight-Hour Time-Restricted Feeding: A Strong Candidate Diet Protocol for First-Line Therapy in Polycystic Ovary Syndrome. Nutrients. 2023 May 10;15(10):2260. doi: 10.3390/nu15102260. PMID: 37242145; PMCID: PMC10223292.
Ismail AM et al. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2014 Sep;180:148-52.
Mooren FC. Magnesium and disturbances in carbohydrate metabolism. Diabetes Obes Metab. 2015 Sep;17(9):813-23. doi: 10.1111/dom.12492. Epub 2015 Jun 23.
Samimi M et al. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2016 Jun;84(6):851-7.
Volpe SL. Magnesium, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus. Crit Rev Food Sci Nutr. 2008 Mar;48(3):293-300. doi: 10.1080/10408390701326235.
